• Yue-Hong Wan, Chen Nie, Hui-Ling Wang, and Chao-Yun Huang.
• Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China.
• J Stroke Cerebrovasc Dis. 2014 Nov 1;23(10):2736-47.

ObjectivesWhether therapeutic hypothermia benefits patients with acute ischemic stroke (AIS) remains controversial. The aim of this study was to evaluate the efficacy and safety of the different depths, durations, and rewarming speeds of therapeutic hypothermia for AIS.MethodsThe MEDLINE (OVID), EMBASE, and Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) of therapeutic hypothermia for AIS from the inception of the databases to October 2013. After data extraction and quality assessment, a meta-analysis was performed using RevMan 5.1.ResultsA total of 6 RCTs involving 252 AIS patients were eligible for the meta-analysis. Subanalyses stratified by depth, duration, and rewarming speed of therapeutic hypothermia were also performed. Our results showed that therapeutic hypothermia was associated with an increased risk of pneumonia (risk ratio = 3.30, 95% CI 1.48-7.34; P = .003, P for heterogeneity = .91, I(2) = 0%). No significant difference was observed between the 2 groups in terms of neurologic outcomes, mortality, and other complications including symptomatic or fatal intracranial hemorrhage, deep vein thrombosis, and atrial fibrillation.ConclusionsThese limited data suggest that therapeutic hypothermia does not significantly improve stroke outcomes and may lead to higher rates of pneumonia. Multicenter RCTs with larger samples are needed to confirm the current findings.Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

30 keywords...

hide…